Provider Demographics
NPI:1285652958
Name:KATKIN, DAVID (LPCC, MED)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:KATKIN
Suffix:
Gender:M
Credentials:LPCC, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 S MINGO LN
Mailing Address - Street 2:
Mailing Address - City:MADEIRA
Mailing Address - State:OH
Mailing Address - Zip Code:45243-1828
Mailing Address - Country:US
Mailing Address - Phone:513-791-1864
Mailing Address - Fax:
Practice Address - Street 1:5720 SIGNAL HILL CT STE A
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1481
Practice Address - Country:US
Practice Address - Phone:513-831-9408
Practice Address - Fax:513-831-1333
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE-0003368101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health